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Biomedical subjects

B Korner

Publications and source records attributed to B Korner.

At least 37 records · Page 2Linked to original sources

Cefotaxime for prevention of infectious complications in bacteriuric men undergoing transurethral prostatic resection. A controlled comparison with methenamine.

Forty-two men with urinary tract infection and benign prostatic hyperplasia were randomized into two groups before transurethral resection. One group (22 patients) received Claforan (cefotaxime) peroperatively and thereafter daily for five days. In the other group (20 patients), Hiprex (methenamine hippurate) was given daily from the day before the operation, for a total of six days. All the bacterial isolates were sensitive to cefotaxime. The efficacy of the medication was clinically and bacteriologically evaluated. Postoperative temperature elevation (greater than 38 degrees C) occurred in one of the 22 patients in the cefotaxime group, and in nine of the 20 in the methenamine hippurate group (p less than 0.05). None of the former group, but two patients in the latter, had septicemia. The difference was not statistically significant. The response to treatment was satisfactory in 13 of the 22 patients in the cefotaxime group, but in only one of the 20 treated with methenamine hippurate (p less than 0.005). Antibiotic treatment is recommended for bacteriuric patients undergoing transurethral prostatic resection.

Aged↗

The value of the micromethod erythrocyte sedimentation rate in the diagnosis of infections in newborns.

200 newborns, gestational age between 27 and 43 weeks (mean 39 weeks) and a birth weight between 900 and 4600 g (mean 2600 g) were studied. 18 patients had severe infections, 20 topical infections, 11 had signs of infection but negative microbiological cultures, 26 had positive cultures but no clinical signs of infection, and 125 patients had no sign of infection at all. In the group without infection (125 patients), the micromethod erythrocyte sedimentation rate (MESR) raised slowly from 2 mm/h at birth (95% upper limit 8 mm/h) to 4 mm/h 8 days after delivery. The MESR of the patients with respiratory distress, asphyxia, intubated children and patients with umbilical catheter, who had no infection, did not differ from other patients in this group. In patients with focal and general infections, rapidly rising MESR within wide limits was observed. Thus, in the individual newborn a high MESR supports the diagnosis of severe infection, whereas a low MESR does not exclude this diagnosis.

Bacterial Infections↗

Netilmicin: efficacy and tolerance in the treatment of systemic infections in neonates.

38 newborn infants, 28 males and 10 females, were treated with netilmicin in doses 6-7 mg/kg/day for suspected or verified infections. 19 patients were mature (mean birth weight 3169 g) and 19 were premature (mean birth weight 1864 g). 32 had moderate or severe underlying diseases. 37 babies survived, 33 were cured or improved markedly and in 4 the results were indeterminate. Pathogenic bacteria were demonstrated in 24 cases and were eliminated in 15. Only one baby died. He suffered from severe respiratory distress syndrome and Escherichia coli septicemia. No E. coli was isolated at autopsy. The mean netilmicin peak serum value was 7.7 micrograms/ml (range 1.0-30.0) and the mean trough concentration 2.1 micrograms/ml (range 0.0-9.2). No adverse effects were seen.

Bacterial Infections↗

Acute Corynebacterium endocarditis causing aortic valve destruction. Successful treatment with antibiotics and valve replacement.

A case of acute infective endocarditis caused by diphtheroids in a healthy young male is described. The pathogenic role of the diphtheroids was verified by recognition of the same bacterium in 6 consecutive blood cultures and simultaneous rise of specific antibody titers. The infection was effectively controlled by antibiotic treatment, but destruction of the aortic valve led to progressive heart failure irresponsive to medical treatment. The affected valve was successfully replaced by a prosthetic valve, and the patient made a complete recovery. Neither congenital or acquired cardiac defects, nor signs of immunological deficiency could be detected.

Adult↗

Fulminant septicemia caused by Yersinia enterocolitica.

A lethal case of septicemia caused by Yershia enterocolitica serotype 3 is described. A 59-year-old male, previously healthy, presented with 6 weeks of fever, abdominal pains and gradual prostration ending in overhelming septicemia and death before a conclusive diagnosis was established. Necropsy showed cirrhosis, haemochromatosis and numerous abscesses in the liver.

Hemochromatosis↗

Sensitivity of Trichomonas vaginalis to metronidazole, tinidazole, and nifuratel in vitro.

Prompted by the sensitivity of trichomonads to metronidazole and nifuratel in clinical practice, a study was conducted in 1971-1972 of 63 consecutive strains of Trichomonas vaginalis isolated from women with clinically refractory vaginal discharge. Their susceptibility to metronidazole, tinidazole, and nifuratel was tested, using a serial tube dilution technique. The minimum concentrations which in 48 hrs caused immobilization and lysis of trichomonads cultured in Diamond's medium was assessed. No differences in drug potency could be determined. The median trichomonistatic and trichomonicidal concentrations were 0-1 and 0-6 mug/ml. respectively when using an inoculum of 10,000 organisms per ml. An inoculum of 100,000 per ml. resulted in inhibitory concentrations of 1-0 and killing concentrations of 3-3 mug./ml. These levels are readily attained in blood and vaginal tissue after oral ingestion of the two imidazole derivatives. Thus, metronidazole has maintained its efficacy since it was first introduced more than a decade ago. The few therapeutic failures with metronidazole and tinidazole are considered to have been caused by pharmacokinetic deficiencies in the patients, or by re-infection.

Drug Resistance, Microbial↗

Yersinia enterocolitica infection in patients with acute surgical abdominal disease. A prospective study.

The rate of yersiniosis in patients with acute abdominal disease was studied in a 16-month prospective investigation in 1972-1973 of 205 acutely ill patients referred to a surgical clinic of a Copenhagen City hospital with complaints of abdominal pain suggestive of appendicitis. Yersinia enterocolitica, biotype 4, was isolated from 11 patients (5.4%), 8 of whom were children. Yersinia was grown from faeces in 8 cases and from appendix of all 9 patients operated upon. Rising or falling agglutinin titres larger than or equal to 100, indicative of yersiniosis, were found in 22 patients (10.7%) including all bacteriologically verified cases. Eight additional patients (3.9%) had less significant titres larger than or equal to 100, suggestive of recent or present infection. 28 patients (13.7%) had insignificant titres, including 3 with antibodies against serotype 9. In all cases except these 3, antibodies were against Y. enterocolitica, serotype 3. A differential diagnosis between Y. enterocolitica infection and other types of appendicitis could not be made within this highly selected group of patients using available clinical data. All cases were rather mild and self-limiting. It is suggested that in future epidemiological and other studies of yersiniosis, early bacteriological and serological examinations be carried out.

Abdomen, Acute↗